Individual
KIERRA DEGALE YOUNGBLOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3650 LAKESIDE DR, SHREVEPORT, LA 71119-6516
(318) 771-4732
(318) 771-4732
Mailing address
1651 E 70TH ST # 264, SHREVEPORT, LA 71105-5115
(318) 771-4732
(318) 606-2104
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
RN-143657
LA
Other
Enumeration date
04/21/2021
Last updated
04/21/2021
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